• Social security advocates know what to look for in your claim that can help or hinder your case. These facts may not only help you win benefits but may also help you get the maximum you are eligible to collect.

• It’s not enough to have a doctor state that you are disabled. Social Security administrators are looking for specific language and types of tests that explain your medical condition before approving your claim. An advocate can advise you of these tests before the hearing.

• Have you appeared before a judge or participated in an appeals hearing? Most people have not. Your advocate will be there with you and will guide you through the complicated process. Your advocate will also prepare witnesses that will testify on your behalf and question or challenge other witnesses at the hearings.

If you need Social Security income to provide for yourself or your family, you cannot afford to go through a lengthy appeals process. An advocate can prevent you from making mistakes that will get you denied. If you need assistance in this area click here.

Paying for Your Own Living Expenses
If you are responsible for paying for your own living expenses then you may be eligible to receive the maximum Social Security Income benefit available to you. This means that if you live on your own (regardless of whether you are a homeowner or you pay rent) and are responsible for paying for your own food and shelter, then chances are you may qualify for the full amount of Social Security Income benefits. Additionally, if you live with someone else, but are still responsible for your own food and housing costs, then you may also still qualify for the full amount of Social Security Income benefits.

Receiving Assistance with Living Expenses
If you reside on your own but receive assistance with your living expenses, then the amount of aid for which you may qualify may be reduced by as much as up to 33% of the Social Security Income Federal benefit rate. In addition, if you reside with someone and do not pay for your own food and housing, or make only partial contributions, then this will also affect the value of the benefits you receive. Exceptions to this apply only to spouses, and parents of minor children.

Living in an Institution
If you reside in an institution such as a hospice, nursing home, hospital or prison then you will receive the greatest cut to your benefits. This, as persons who have been institutionalized can only qualify for benefits not exceeding $30 per month. In addition, to qualify for this $30 the institution has to be one where Medicaid covers more than 50% of your healthcare costs.

Homeless
Finally, being homeless does not exempt you from receiving Social Security Income disability benefits. If you are homeless you may still qualify for the maximum benefits available to you. Additionally, if you reside in a safe haven facility that supplies the homeless with cheap housing then your benefits will not be affected. However, if you have taken refuge in a shelter this will have an impact on your benefits, as you may only receive benefits for approximately six months of the duration of your stay there.

1. Applicants should have a healthy skepticism for the “system” and should know that they will likely face an uphill battle to appeal a denial; this is unfortunate but the SSA must protect themselves against those who abuse the system; also, applicants and their advocates (usually a lawyer) need to check and double check that everything is filed properly – don’t count on the SSA contacting to remind you of all the deadline dates and requirements

2. Examiners do not have an emotional investment in your claim; to make yours stand out, you must include detailed medical records that illustrate your physical limitations, prognosis, and especially your limitations due to the disability

3. You will probably need much more than just one doctor’s opinion that you have a disability; be prepared to submit to additional exams and provide more supporting documents than one doctor’s notes

4. Time is crucial and you can apply for disability as soon as you become disabled; there will be waiting periods but it is possible to eventually receive back pay; do not procrastinate!

5. You should definitely find a disability lawyer; many are willing to work out payment plans to make their services affordable.

The Social Security Administration approves and denies claims based on whether or not a claimant is able to work. Social Security Disability is awarded to persons with an ongoing medical condition that hinders job performance. When making disability decisions, examiners look at medical records and what that information says about one’s ability to work. Examiners review the records to help determine what can and can’t be performed because of the impairment (residual functional capacity). Social Security examiners will analyze if a claimant can return to their past work, which could be any job they have performed within the last 15 years and whether or not a claimant can perform some type of other employment for which they are suited based on age, education, skills, and mental or physical limitations. They then examine vocational guidelines to determine if the person can earn a living wage. If a claimant is found by a disability examiner to be capable of working, the claim will be denied.

For example, a person has filed for disability who has worked for 15 years in a very physical job where he is living heavy items all day during the workweek. A physical disability limits him to only light work. His condition is expected to last at least 12 months or longer. Social Security examiners will deem this claimant as unable to return to past work. Remember that receiving Social Security benefits does not mean a person can’t work. In actuality, it means that a disabled person can’t have the ability to work and earn more than a certain threshold of income.

Claimants can improve their chances of receiving benefits by having a solid work history they can report to the examiner. It also helps to provide contact information for former supervisors and to detail all the duties one has performed previously on the job. Former supervisors should discuss all the demands placed from the job as well as skill sets one has acquired.

You have 60 days to file an appeal after you receive your letter which is called the initial denial. Reconsideration is the next level of appeal. You can pick up forms at your local Social Security office, request them by mail or check online. The Reconsideration request is reviewed by a different set of employees and not the ones who first reviewed your request.

Many people give up after they are denied a second time. However, you have 60 days to request a hearing before an Administrative Law Judge. The judge will hear from the claimant and any witnesses. The judge does not work for the Social Security Administration and decides based on the evidence presented.

If the judge denies the claim, you can appeal to the Appeals Council. A claimant can appear before the council if the council agrees to review the case. If the council will not review the case or if the case is denied, you can file in the U.S. District Court. If the court sides with the claimant, the case is sent back to the Administrative Law Judge.

The appeals process can take more than a year and involves several complicated steps. If you don’t meet the deadlines your claim can be denied and you will have to file your claim again. Many people hire an advocate or attorney to help them with their appeal.

No More Social Security Paper Checks

1. Keep your lawyer informed and give them all the information they request regarding your case; this will usually include financial and medical information, so be prepared to share personal information; if you aren’t sure if something is relevant, ask them and assume that they will determine what is useful and what can be disregarded

2. Carefully prepare timelines, summaries, and accurate materials; it is not your lawyer’s job to fix your mistakes

3. Know what the deadlines are for your case and have the information to your attorney in a timely manner; give them as much notice as possible if something needs to be rescheduled

4. Keep your questions short and to the point; lawyers are generally very busy and do not have time to sift through irrelevant details

5. Honor the payment plan and make sure you pay your lawyer fees on time.

1. Your income is too high – this only includes work income, not income from other sources such as investments; the limits change at least yearly, so check the SSA’s website for the current income limits

2. Your disability is likely short term – the SSA must determine that your disability will last longer than 12 months or will result in a fatal condition; in the case of traumatic accidents like a car accident, the application might be denied because the SSA assumes that bone fractures and other traumas will heal within a year

3. You are incommunicato – make sure that your address, phone number, email, and other contact information is valid and current; it is not the SSA’s responsibility to track you down if they cannot contact you or your representative (likely a lawyer)

4. You do not cooperate – this means that you should give the SSA access to your medical records that you are using to prove your disability; the SSA can also request that you submit to an exam by one of their doctors in a consultative examination (CE); it is in your best interest to cooperate

5. You do not follow prescribed therapy – if you are under a doctor’s care but do not follow their prescribed therapy when you do have the ability to do so, your SSDI claim may be denied; there are some accepted medical excuses, including mental illness, valid religious beliefs, or your treatment plan is harmful or incorrect

6. Your disability is based on alcohol or drug addiction – these cases are sometimes denied but can be approved if the SSA determines that the disability would still be present even without the use of drugs or alcohol

7. You have been convicted of a crime – if you are in prison at the time of your application, it could be denied, especially if your disability was a direct result of commiting the crime

8. You commit fraud.

Steve Goss, Chief Actuary
Social Security Administration
April 3, 2012

2012 Disability Statistics

Benefit payments can also be affected by other types of public disability payments. Payments from worker’s compensation or temporary state disability payments can lower the amount of SSDI received. However, SSI or VA benefits will not affect SSDI payments.

Most SSDI recipients will also receive a lump sum payment of past due benefits to cover the time between the initial application and the approval. Some applicants may also receive additional backpay from the time they actually became disabled (as much as 12 months prior to the application). These payments can be significant and amount to thousands of dollars.

Finally, Medicare is awarded to recipients two years after the time they are deemed eligible for SSDI. This is not the date of application, but rather the date of entitlement, which is the disability onset date plus 5 months.